Medical Billing &Coding Specialist

Medical Billing &Coding Specialist

Medical billing and coding specialists, also known as medical billers and coders, work as a liaison between medical offices and insurance companies to manage insurance claims, invoices, and payments. Includes translating patient records into universal medical alphanumeric codes for billing and insurance reimbursement, medical research, and creating and submitting claims to insurance companies and patients to collect payment.

DC Registration Required? No

Projected DC Annual Job Openings: 80*

Average DC Yearly Salary: $61,320*

Certifying Bodies, Examinations, and Requirements

The American Health Information Management Association (AHIMA) is the most widely recognized certifying agency for medical coding and billing certifications. The AHIM offers a variety of certifications including Certified Coding Associate, Certified Coding Specialist, Certified Coding Specialist - Physician Based, and Registered Health Information Technician. Learn more about the certification exams and their requirements:

AHIMA Certified Coding Associate (CCA) Exam

• Possession of a high school diploma or its equivalent;
• Possession of one approved ICD-10-CM code book (2024), one approved ICD-10-PCS code book (2024), American Medical Association’s CPT® 2024 Professional Edition
• Recommended:
  • 6 months of coding experience directly applying codes
  • Completion of an AHIMA-approved coding program
  • Completion of other coding training program to include anatomy & physiology, medical terminology, basic ICD diagnostic/procedural and basic CPT coding

AHIMA Registered Health Information Technician (RHIT) Exam

• Successfully complete the academic requirements, at an associate's degree level, of a Health Information Management (HIM) program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM)

AHIMA Certified Coding Specialist (CCS) Exam

• Possession of a high school diploma or its equivalent;
• Possession of one approved ICD-10-CM code book (2024), one approved ICD-10-PCS code book (2024), American Medical Association’s CPT 2024 Professional Edition
• Recommended:
  • Complete courses in anatomy & physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate/advanced ICD diagnostic coding, and procedural coding and medical services (CPT/HCPCS) plus 1 year of coding experience directly applying codes; OR
  • Minimum of 2 years of related coding experience directly applying codes; OR
  • CCA credential plus 1 year of coding experience directly applying codes; OR
  • Coding credential from another certifying organization plus 1 year of coding experience directly applying codes; OR
  • CCS-P, RHIT, or RHIA credential

AHIMA Certified Coding Specialist - Physician Based (CCS-P) Exam

• Possession of a high school diploma or its equivalent.
• Possession of one approved ICD-10-CM code book (2024), one approved HCPCS Level II code book (2024), American Medical Association’s CPT 2024 Professional Edition
• Recommended:
  • Complete courses in anatomy & physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate/advanced ICD diagnostic coding, and procedural coding and medical services (CPT/HCPCS) plus 1 year of coding experience directly applying codes; OR
  • Minimum of 2 years of related coding experience directly applying codes; OR
  • CCA credential plus 1 year of coding experience directly applying codes; OR
  • Coding credential from another certifying organization plus 1 year of coding experience directly applying codes; OR
  • CCS, RHIT, or RHIA credential

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